dr-yakelin-sosaYou’ve reached the point in life when most things seem to be going well– career, weight, relationships, finances.

And then it hits you, something you can’t control: aging!

How can this be, that just when you are at your most confident, successful, and least stressed, that you could lose your mojo?

Welcome to the facts of life. Aging causes the production of hormones (such as estrogen, testosteroneand HGH) to slow to a trickle. This has the effect of thinning one’s hair, twisting the body’s thermostat, interfering with memory and concentration, increasing abdominal fat, and drying up the natural lubricants.

So do you have to be rich and famous to look younger every year? Here is one trick: hormone replacement therapy (HRT), and it’s been around forever. But haven’t you heard horror stories about HRT and heart disease, or even cancer? Didn’t someone say that doctors don’t prescribe it anymore? Well, the truth is not that simple. For some people, HRT is effective. For others, it’s not recommended. For most of us, it’s complicated.

And yes, physicians still prescribe HRT all across the country, and in Europe.

At my MedSpa in Miami , I see countless patients who don’t understand the changes they’re experiencing.

hgh-decline-graph-300x241Once hormone levels drop below 45%, we begin to feel ‘old’ like never before. This is when symptoms– like hot flashes, night sweats, memory loss, mood swings, weight gain, stiff joints and low libido– begin to make themselves felt.

Replacing those vital hormones with a bio-identical hormone formulation is one key to youth.”

 

Pros and Cons of Hormone Replacement Therapy

But let’s look at the science. In 2002, the Women’s Health Initiative– a study of more than 160,000 women who’d been through menopause– found there was a slight increase in cancer among women were given estrogen-progesterone therapy for five years.

Women who were administered estrogen-only treatment were slightly less likely to develop breast cancer.

The study also showed higher risk of blood clots, stroke and heart disease among women who were prescribed estrogen only. Confusion ensued!

Then, in July 2013, a group of researchers from Yale University School of Medicine made headlines when they announced that nearly 50,000 women had died prematurely because hormone therapy waswithheld. (Most of the deaths were caused by heart disease or breast cancer.)

This paper, which was published in the American Journal of Public Health, encouraged patients to discuss hormone treatment with their doctors, and concluded that some women are good candidates for treatment while others should approach the subject with caution.

Checklist for HRT Candidates

So which group do you fall into? Here’s a seven-point checklist to help give you a framework for that talk with your doctor:

  1. Age. Women under the age of 60 stand to benefit most from a regimen of HRT, according to the British Menopause Society. The researchers recommend starting with low-dose HRT for women over 60.
  2. Women with a risk of cardiovascular disease (heart attacks and stroke) are candidates for HRT. But, if you have high blood pressure, that needs to be addressed first.
  3. As far as boosting your sex life, HRT (estrogen, progesterone, androgen or testosterone) is an option. The question is whether you want to reverse the vaginal dryness or the sagging libido– or both.
  4. Moody? Many women experience depression with the menopause, but diagnosing the root cause is tricky. If HRT doesn’t do the job, an antidepressant might be in order.
  5. HRT remains ‘the first-line therapeutic intervention and treatment of osteoporosis’, in the words of the British Menopause Society. Since complications from broken bones are a major cause of death in women, this is not to be taken lightly.
  6. Last summer, researchers from Wake Forest School of Medicine found that HRT does not seem to interfere with memory. Current thinking is, you should not take HRT only to improve memory and concentration.
  7. Cancer. Hormones and dosage will depend on your medical and family histories. If you have had endometrial, breast or ovarian cancer, it’s even more important to have that discussion with your doctor.

Although HRT has gotten some bad press in recent years, Mayo Clinic says there is enough evidence tosupport prescribing it for hormone-related problems.

So, bottom line? It’s up to you (and your doctor) to decide whether your symptoms merit treatment. And like any important decision in your life, it requires some careful deliberation.

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